Epic Claims Aggregation

Applicants must be currently authorized to work in the United States. ChristianaCare will not sponsor applicants for this position for an employment visa now or in the future.

Why ChristianaCare

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare

ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of "America's Best Hospitals by U.S. News & World Report, we have an excess of 1,100 beds between our hospitals and are committed to providing the best patient care in the region. We are proud to that Christiana Hospital, Wilmington Hospital, our Ambulatory Services, and HomeHealth have all received ANCC Magnet Recognition .

ChristianaCare Offers

• Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions.
• Generous paid time off with annual roll-over and opportunities to cash out.
• 12-week paid parental leave
• Tuition assistance
• Incredible Work/Life benefits including annual membership to access to backup care services for dependents through retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more

Why Epic

The electronic health record (EHR) is foundational to the care we provide because it centralizes patient information, enabling informed decision-making and seamless care coordination. The EHR supports our ability to deliver high-quality, equitable, accessible care.

ChristianaCare is excited to transition from Cerner to Epic as the EHR across our sites of care

This role is a HYBRID position requiring frequent on-site work. Must be within a commutable distance.

Epic certification preferred; if not certified, must become Epic certified within 3 weeks of completing the mandatory Epic training sessions.

Must be available to travel for Epic training the week of 3/31/2025.

Education and Experience Requirements:

• Bachelor's degree in Information Technology, Computer Science, Data Analytics, Healthcare Administration, or a related field is preferred.
• 2 - 3 years of experience working with Epic systems or similar EHR platforms preferably in claims analysis or a related field.
• High School diploma with 5 years of related experience may be considered in lieu of bachelor's degree.
• Epic Caboodle Data Model Certification preferred
• Relevant certifications in data management, SQL, or Epic systems are highly desirable

Principal Duties and Responsibilities:

• Working with the Caboodle DBA and Data Aggregation Application Coordinator DAC to set up the file transfer process FTP and create the required folder structure to load files from the payers for claims data aggregation.
• Downloading all the informational files needed for the claims loads and setting up a process to do that on a regular basis.
• Working with the DAC to document the issues and gaps during the design mapping and validation process and communicating that to the project manager with specific follow ups for the payers.
• Working with the Caboodle DBA to configure and monitor executions for the claims load.
• Coordinating with the Caboodle DBA and Healthy Planet team to ensure all the claims dependent data from Chronicles Patient, Medications, Procedures, and so on makes it to Caboodle.
• During the claims technical validation and operational validation, working with the DAC, the Healthy Planet team, and the Caboodle DBA to investigate technical issues and communicate those to the project manager.
• Coordinating with the DBA to perform configuration for claims connectors and Healthy Planet functionality like Cost and Utilization dashboard and Datalink in Caboodle.
• Working with the Caboodle DBA to configure and monitor executions for the claims load.
• Migrating the connectors to the production environment as part of the technical cutover, following the technical steps from the cutover documentation.
• Coordinating with the DBA and DAC to configure the executions and load files in the production environment.
• Serving as the main point of contact for technical issues and general inquiries related to assigned applications
• Working in collaboration with Epic to implement new projects such as a new module
• Managing upgrades of assigned applications with Epic by setting timelines, maintaining continuous communication, and addressing issues
• Analyzing and communicating the impact of issues
• Triaging requests and determining the priority of issues
• Resolving end user application issues using Epic documentation and ensuring business needs are met
• Advancing end user problems to the appropriate level such as team lead when necessary
• Validating solutions are complete and appropriately implemented
• Building relationships with end users and providing consistent support through day to day communication
• Communicating problem status and solutions to end users
• Post go live support:
  • Ensuring extracts are created and received from the payer's source on a timely basis
  • Ensuring files land in the right folders for the ETL to process and load data
  • Working with the Caboodle DBA to monitor eligibility, claims, and information file loads
  • Working with the Caboodle DBA to investigate file transfer and ETL load issues for external data
  • Reviewing upgrade change logs and working with Epic counterparts to coordinate upgrade testing.